CT fluoroscopy-guided biopsy of the lung or upper abdomen with a breath-hold monitoring and feedback system: A prospective randomized controlled clinical trial

Stephanie K Carlson, Joel P. Felmlee, Claire E. Bender, Richard Lorne Ehman, Kelly L. Classic, Tanya L. Hoskin, William S. Harmsen, Houchun H. Hu

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

PURPOSE: To prospectively determine the clinical effectiveness of a breath-hold monitoring and feedback system in computed tomographic (CT) fluoroscopy-guided biopsies in which respiratory motion is a problem. MATERIALS AND METHODS: Institutional review board approval and oral and written informed consent were obtained. This study was HIPAA compliant. A bellows-based system was used to monitor respiration and provide patient feedback. A randomized controlled clinical trial compared intermittent mode CT fluoroscopy-guided biopsies of the lung or upper abdomen performed with (n = 56) and without (n = 57) the bellows system. Inclusion criteria for 113 patients were lesions 6 cm or smaller in maximum dimension that were not affixed to the chest or abdominal wall. Primary outcome measurements were CT fluoroscopy exposure time and patient dose. Wilcoxon rank sum, χ2, and Fisher exact tests were used for statistical analysis. RESULTS: Median CT fluoroscopy exposure time was 12.6 seconds (range, 2.4-44.4 seconds) for the bellows group and 18.0 seconds (range, 6.0-118.0 seconds) for the nonbellows group (P = .004). Patient dose was decreased in the bellows group (median dose, 29.5 mGy; range, 4.7-135.8 mGy) versus the nonbellows group (median, 41.3 mGy; range, 11.8-155.9 mGy) (P = .01). Lesions were accessed successfully with one needle puncture attempt in 43 of 56 patients (77%) in the bellows group and 30 of 57 patients (53%) in the nonbellows group (P = .007). Pneumothorax developed in 11 of 50 patients (22%) in the bellows group who underwent lung biopsy compared with 16 of 50 (32%) patients in the nonbellows group. CONCLUSION: A breath-hold monitoring and feedback system allows depiction of mobile target lesions throughout CT fiuoroscopy-guided biopsy of the lung and upper abdomen.

Original languageEnglish (US)
Pages (from-to)701-708
Number of pages8
JournalRadiology
Volume237
Issue number2
DOIs
StatePublished - Nov 2005

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Fluoroscopy
Abdomen
Randomized Controlled Trials
Biopsy
Lung
Health Insurance Portability and Accountability Act
Research Ethics Committees
Abdominal Wall
Thoracic Wall
Pneumothorax
Informed Consent
Punctures
Needles
Respiration

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

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CT fluoroscopy-guided biopsy of the lung or upper abdomen with a breath-hold monitoring and feedback system : A prospective randomized controlled clinical trial. / Carlson, Stephanie K; Felmlee, Joel P.; Bender, Claire E.; Ehman, Richard Lorne; Classic, Kelly L.; Hoskin, Tanya L.; Harmsen, William S.; Hu, Houchun H.

In: Radiology, Vol. 237, No. 2, 11.2005, p. 701-708.

Research output: Contribution to journalArticle

Carlson, Stephanie K ; Felmlee, Joel P. ; Bender, Claire E. ; Ehman, Richard Lorne ; Classic, Kelly L. ; Hoskin, Tanya L. ; Harmsen, William S. ; Hu, Houchun H. / CT fluoroscopy-guided biopsy of the lung or upper abdomen with a breath-hold monitoring and feedback system : A prospective randomized controlled clinical trial. In: Radiology. 2005 ; Vol. 237, No. 2. pp. 701-708.
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abstract = "PURPOSE: To prospectively determine the clinical effectiveness of a breath-hold monitoring and feedback system in computed tomographic (CT) fluoroscopy-guided biopsies in which respiratory motion is a problem. MATERIALS AND METHODS: Institutional review board approval and oral and written informed consent were obtained. This study was HIPAA compliant. A bellows-based system was used to monitor respiration and provide patient feedback. A randomized controlled clinical trial compared intermittent mode CT fluoroscopy-guided biopsies of the lung or upper abdomen performed with (n = 56) and without (n = 57) the bellows system. Inclusion criteria for 113 patients were lesions 6 cm or smaller in maximum dimension that were not affixed to the chest or abdominal wall. Primary outcome measurements were CT fluoroscopy exposure time and patient dose. Wilcoxon rank sum, χ2, and Fisher exact tests were used for statistical analysis. RESULTS: Median CT fluoroscopy exposure time was 12.6 seconds (range, 2.4-44.4 seconds) for the bellows group and 18.0 seconds (range, 6.0-118.0 seconds) for the nonbellows group (P = .004). Patient dose was decreased in the bellows group (median dose, 29.5 mGy; range, 4.7-135.8 mGy) versus the nonbellows group (median, 41.3 mGy; range, 11.8-155.9 mGy) (P = .01). Lesions were accessed successfully with one needle puncture attempt in 43 of 56 patients (77{\%}) in the bellows group and 30 of 57 patients (53{\%}) in the nonbellows group (P = .007). Pneumothorax developed in 11 of 50 patients (22{\%}) in the bellows group who underwent lung biopsy compared with 16 of 50 (32{\%}) patients in the nonbellows group. CONCLUSION: A breath-hold monitoring and feedback system allows depiction of mobile target lesions throughout CT fiuoroscopy-guided biopsy of the lung and upper abdomen.",
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T1 - CT fluoroscopy-guided biopsy of the lung or upper abdomen with a breath-hold monitoring and feedback system

T2 - A prospective randomized controlled clinical trial

AU - Carlson, Stephanie K

AU - Felmlee, Joel P.

AU - Bender, Claire E.

AU - Ehman, Richard Lorne

AU - Classic, Kelly L.

AU - Hoskin, Tanya L.

AU - Harmsen, William S.

AU - Hu, Houchun H.

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N2 - PURPOSE: To prospectively determine the clinical effectiveness of a breath-hold monitoring and feedback system in computed tomographic (CT) fluoroscopy-guided biopsies in which respiratory motion is a problem. MATERIALS AND METHODS: Institutional review board approval and oral and written informed consent were obtained. This study was HIPAA compliant. A bellows-based system was used to monitor respiration and provide patient feedback. A randomized controlled clinical trial compared intermittent mode CT fluoroscopy-guided biopsies of the lung or upper abdomen performed with (n = 56) and without (n = 57) the bellows system. Inclusion criteria for 113 patients were lesions 6 cm or smaller in maximum dimension that were not affixed to the chest or abdominal wall. Primary outcome measurements were CT fluoroscopy exposure time and patient dose. Wilcoxon rank sum, χ2, and Fisher exact tests were used for statistical analysis. RESULTS: Median CT fluoroscopy exposure time was 12.6 seconds (range, 2.4-44.4 seconds) for the bellows group and 18.0 seconds (range, 6.0-118.0 seconds) for the nonbellows group (P = .004). Patient dose was decreased in the bellows group (median dose, 29.5 mGy; range, 4.7-135.8 mGy) versus the nonbellows group (median, 41.3 mGy; range, 11.8-155.9 mGy) (P = .01). Lesions were accessed successfully with one needle puncture attempt in 43 of 56 patients (77%) in the bellows group and 30 of 57 patients (53%) in the nonbellows group (P = .007). Pneumothorax developed in 11 of 50 patients (22%) in the bellows group who underwent lung biopsy compared with 16 of 50 (32%) patients in the nonbellows group. CONCLUSION: A breath-hold monitoring and feedback system allows depiction of mobile target lesions throughout CT fiuoroscopy-guided biopsy of the lung and upper abdomen.

AB - PURPOSE: To prospectively determine the clinical effectiveness of a breath-hold monitoring and feedback system in computed tomographic (CT) fluoroscopy-guided biopsies in which respiratory motion is a problem. MATERIALS AND METHODS: Institutional review board approval and oral and written informed consent were obtained. This study was HIPAA compliant. A bellows-based system was used to monitor respiration and provide patient feedback. A randomized controlled clinical trial compared intermittent mode CT fluoroscopy-guided biopsies of the lung or upper abdomen performed with (n = 56) and without (n = 57) the bellows system. Inclusion criteria for 113 patients were lesions 6 cm or smaller in maximum dimension that were not affixed to the chest or abdominal wall. Primary outcome measurements were CT fluoroscopy exposure time and patient dose. Wilcoxon rank sum, χ2, and Fisher exact tests were used for statistical analysis. RESULTS: Median CT fluoroscopy exposure time was 12.6 seconds (range, 2.4-44.4 seconds) for the bellows group and 18.0 seconds (range, 6.0-118.0 seconds) for the nonbellows group (P = .004). Patient dose was decreased in the bellows group (median dose, 29.5 mGy; range, 4.7-135.8 mGy) versus the nonbellows group (median, 41.3 mGy; range, 11.8-155.9 mGy) (P = .01). Lesions were accessed successfully with one needle puncture attempt in 43 of 56 patients (77%) in the bellows group and 30 of 57 patients (53%) in the nonbellows group (P = .007). Pneumothorax developed in 11 of 50 patients (22%) in the bellows group who underwent lung biopsy compared with 16 of 50 (32%) patients in the nonbellows group. CONCLUSION: A breath-hold monitoring and feedback system allows depiction of mobile target lesions throughout CT fiuoroscopy-guided biopsy of the lung and upper abdomen.

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